Kim Young Soo, Jung Keun Hwa, Lee Soon Tae, Kang Bong Su, Yeom Jung Sook, Moon Jangsup, Shin Jung Won, Lee Sang Kun, Chu Kon
Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
J Clin Neurol. 2016 Apr;12(2):224-9. doi: 10.3988/jcn.2016.12.2.224. Epub 2016 Jan 28.
Herpes simplex encephalitis (HSE) is the most common type of sporadic encephalitis worldwide, and it remains fatal even when optimal antiviral therapy is applied. There is only a weak consensus on the clinical outcomes and prognostic factors in patients with HSE. This study examined whether the radiological and electrophysiological findings have a prognostic value in patients with HSE.
We retrospectively analyzed patients who were diagnosed with HSE by applying the polymerase chain reaction to cerebrospinal fluid and who received intravenous acyclovir at our hospital from 2000 to 2014. We evaluated the clinical outcomes at 6 months after onset and their correlations with initial and clinical findings, including the volume of lesions on MRI, the severity of EEG findings, and the presence of epileptic seizures at the initial presentation.
Twenty-nine patients were enrolled (18 men and 11 women). Univariate analysis revealed that the presence of severe EEG abnormality and epileptic seizures at the initial presentation were significant correlated with a poor clinical outcome at 6 months (p=0.005 and p=0.009, respectively). In multivariate analysis, the presence of severe EEG abnormality was the only independent predictor of a poor outcome at 6 months (p=0.006).
In cases of HSE, the initial EEG severity and seizure presentation may be useful predictive factors for the outcome at 6 months after acyclovir treatment.
单纯疱疹性脑炎（HSE）是全球最常见的散发性脑炎类型，即便采用最佳抗病毒治疗，其仍可致命。对于HSE患者的临床结局和预后因素，仅存在微弱的共识。本研究探讨了影像学和电生理检查结果对HSE患者是否具有预后价值。
我们回顾性分析了2000年至2014年期间在我院通过脑脊液聚合酶链反应诊断为HSE并接受静脉注射阿昔洛韦治疗的患者。我们评估了发病6个月后的临床结局及其与初始和临床检查结果的相关性，包括MRI上病变的体积、脑电图检查结果的严重程度以及初始表现时癫痫发作的情况。
共纳入29例患者（18例男性和11例女性）。单因素分析显示，初始表现时严重脑电图异常和癫痫发作与6个月时不良临床结局显著相关（分别为p = 0.005和p = 0.009）。多因素分析中，严重脑电图异常的存在是6个月时不良结局的唯一独立预测因素（p = 0.006）。
在HSE病例中，初始脑电图严重程度和癫痫发作表现可能是阿昔洛韦治疗后6个月结局的有用预测因素。
